A group of health care advocates on Wednesday urged the Vermont Senate to support legislation that is designed to reduce administrative burdens for providers.
The bill would streamline the process for ordering key tests and prescribing drugs.
Dr. Kristin Connolly is a pediatrician in Milton. She says she's become increasingly frustrated when insurance companies require prior authorization before she can provide certain services for her patients.
She says in some cases, this process delays critical treatment.
"These unnecessary prior authorizations and frequently changed medication formularies are not motivated by improving patient care or reducing patient costs — in fact many are not even consistent with clinical guidelines," Connolly says. "The effects on patients and risks to patient health are tremendous."
"These unnecessary prior authorizations and frequently changed medication formularies are not motivated by improving patient care or reducing patient costs ... The effects on patients and risks to patient health are tremendous."Dr. Kristin Connolly
Blue Cross and Blue Shield of Vermont is the largest health insurance company in the state.
Public policy director Sara Teachout says they're concerned the bill would raise costs.
She says Blue Cross tries to have a collaborative relationship with providers to balance medical needs with cost effective care.
And she's disappointed they're being portrayed as a company that only looks at the bottom line.
"You know I think that's really unfortunate. Blue Cross and Blue Shield of Vermont does everything we can to improve patient safety, rein in costs and make sure that the care that's being provided is appropriate for the situation," Teachout says. "We never want to deny care for our members — that's not good for people and we know that."
Teachout says Blue Cross estimates that if the bill passes, insurance rates could rise between 5 and 7%.
Last month, the House approved the bill by a vote of 137 to 0.
"Because insurance companies are making categorical denials more than they ever have and it's really wreaked havoc with our practitioners."Ginny Lyons, Health and Welfare committee chair
Lori Houghton, chair of the House Health Care committee, disputes Blue Cross' cost projections.
She argues providing timely care to many patients will actually help reduce costs.
"So, if someone needs a medication or someone needs a test and they can get that without all the burdensome paperwork and get whatever ails them fixed and they're healthy, absolutely costs will be reduced."
The outlook for the bill in the Vermont Senate is looking good. That's because it's a top priority for Ginny Lyons, Health and Welfare committee chair.
"Because insurance companies are making categorical denials more than they ever have and it's really wreaked havoc with our practitioners."
Lyons says her committee will take a detailed look at this legislation in the coming weeks.
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